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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVED LUC E - OCT 14 2020 p © �. M Buildin Permit A lication St.Lucie County g pp Permitting Planning and Development Services Building and Code Regulation Division Commercial Residential V/- 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)4C2=1553 Fax: (772)462-1578 CBDG Funding PERMIT APPLICATION FOR: PROP.OSED'IMPROVEMENT`LOCATION: Address: �&% esuo5 k S14 �-'do Q,tcc,e, FL - -- Property Tax ID#:- I46z,-609-•0L1$-00c)• I - - Lot No. ZO Site Plan Name: R:,v e-r ESV*4S Block No. Scl Project Name: DETAILED DESCRIPTION,OF.WORK: 0g.6oye- 'FcocxA- -er*ry dooc tdCK, 36 New Electrical Meter Second Electrical Meter (Affidavit required) 'CONSTRUCTION INFORMATION: ` Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond _Electric _Plumbing _Sprinklers _Generator _Roof Pitch -Total-Sq. Ft-of_Construction:__ 6_ZU_ _ Sq. Ft.-of First Floor: Cost of Construction:$ HZO.oc> Utilities: —Sewer _Septic Building Height: I$ ��- OWNER/LESSEE:. CONTRACTOR: Name `J�avn 4 PtSWt-i C sS Name: Address: S6o4S- Skmse. 9\4 Company: C-i,> 4 L City: hack .P,8a.e State: '�L- Address: 5- Zip Code: '349 tZ Fax: City: P 4 bP--� State: Phone No.77 7- 4 aVt. -610 I E- Zip Code:7 � / _Fax:, -Opz-yZ2 Mail: 5\.G.un CoS�H3Z aLalhat�.Ceram Phone No 7 �� Fill in fee simple Tide Holder on next page(if different E-Mail from the Owner listed above) State or County License C (J �� If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL,CONS 7TION LIEN LAW INFORNtAT10N DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ of Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _L,/Vot Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no representation that is grantigg a permit will authorize the permit holder to build the subject structure which conflicts with any,applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Homeowners Association and review yourdeed for any restrictions which may.apply. In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use WARNING TO OWNER:Your failure to Record a Notice.of Commencement may result in paying twice for improvements to your property:A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIQA, COUNTY OF / Sworn to(or affirmed)and subscribed before me of ✓ Physical Presence or Online Notarization .this-A--day of __ .20Z1 by �*Ncyun l ' Name of person making statement. _ Personally Known OR Produced Identification Type of Identification Produced -V---- — -- — -- -- - — — - - - — - - (Si at a of Notary Pu c- a of Florida) ►�Y r� KRISTIE KIRSTEIN Commission-No.GA 2.7Z172(Seal) .••"•. commissions 062 12 Exp1ras? 20 o saia.anwerr REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev 20121